Is Blue Button a short-term solution for interoperability? — CMS issues final rule for ICD-10 transition

By Ashley Gold

08/01/14 10:04 AM EDT

IS BLUE BUTTON A SHORT-TERM SOLUTION FOR INTEROPERABILITY? While the health IT world rumbles with complaint about the tangled lack of interoperability in the health care world, and Congress authorizes billions to improve care coordination for veterans, a little app is waving its arms up and down saying, “Use me! Use me!” A government-developed mobile platform called Blue Button allows patients to take their health data with them anywhere — to different doctors and medical systems, through Medicare and between the Pentagon and the Department of Veterans Affairs. One of the leading apps for Blue Button was developed by a tiny company called Humetrix. Northrop Grumman and Microsoft also have versions of Blue Button, which was released through the Office of the National Coordinator for Health IT. ONC director Karen DeSalvo recently laid out a ten-year plan for reaching full system interoperability, but ten years is a long time. Congress is starting to reflect the anger many doctors and health IT professionals feel over the fact that $25 billion in federal meaningful use incentives have financed electronic health records systems that usually don’t talk to one another. That’s where Humetrix and other mobile app developers hope to come in, and in some cases, already have:

Lygeia Riccardi, of the recently departed from ONC, told POLITICO: “If every patient/consumer used Blue Button, in theory the interoperability problem would be solved because patients could share data among members of their care teams... [but] asking whether EHRs would be obsolete if every patient used Blue Button is a little like asking if radios are obsolete because nearly everyone has a TV… . There is some overlap in the functions EHRs and Blue Button can enable (sharing health records) but each also offers unique capabilities.” http://politico.pro/1s72zh9

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eHealth tweet of the day: @TNSmallBiz: From space to electronic health records: How Medhost President Craig Herrod built his career... dlvr.it/6TdLr7 One small step for EHRs, one giant leap for mankind.

Welcome to Friday morning eHealth! Byron Tau of POLITICO Influence suggested shorthand for our newsletter here: MeH. Do you like it? Email other suggestions to agold@politico.com and connect with us on Twitter @POLITICOPro; @Morning_eHealth.

IT’S OFFICIAL: ICD-10 SWITCHOVER DAY IS OCT. 1, 2015: HHS issued a rule Thursday formalizing Oct. 1, 2015 as the official start date for using ICD-10 billing codes. Doctors, hospitals and health plans earlier had been preparing for a launch this October, but Congress mandated that it be delayed at least a year. Some had speculated the date might get delayed again, but this is a final rule — no comment period. Here’s the rule: http://bit.ly/1s9albp AHIMA praised the decision, saying the IT industry now has the certainty to move forward with testing and training.

BROADBAND: THE OTHER BIG OBSTACLE TO TELEMEDICINE: A lack of good Internet connections is nearly as big an obstacle to increasing telemedicine as the lack of Medicare funding for the services, witnesses told a congressional hearing Thursday. Many hospitals and doctors’ offices across the country lack broadband or fiber-optic cabling with the necessary bandwidth to use certain forms of telemedicine, said Maggie Basgall of Lenora, Kan.’s Nex-Tech, a broadband-service provider for rural areas in the upper Midwest. Many patients lack wireless capabilities and are still reliant on dial-up Internet. “Without that, they can’t do in-home telemedicine,” Basgall said following a House Small Business Health and Technology Subcommittee hearing. Although there are 46 telemedicine-related bills pending before Congress, the hearing was just the second devoted to the issue this year. A bill is expected to be brought to the floor in 2015. “What our purpose was today, and I think we’ve done it, was to start a discussion,” said Rep. Chris Collins, chairman of the subcommittee. “If we don’t start the discussion at some point, we’re seeing a hodge-podge of things move forward, state by state.” Full story from David Pittman: http://politico.pro/UEbQRF

QUANTIFIED SELF LAWMAKERS: REP. MICHAEL BURGESS: I’m hoping to feature lawmakers who use mHealth in MeH on a regular basis — know of one? Ping me! Yesterday, I caught up with Rep. Michael Burgess (R-Tx.), who’s also a physician, and talked to him about his pedometer and mHealth apps. He said walking from the Reagan building to the House floor for votes rather than taking the tram gives him 700 extra steps per day. He walks way more in Washington than back in Texas, Burgess said. “The pedometer gives me positive reinforcement, which can be few and far between around here,” Burgess said. “This morning, I put it on late and I’m mourning the loss of steps I’ll never get back.”

Burgess also has his scale, blood pressure cuff and pulse oximeter send readouts to his iPhone. “My belief is in personalized medicine, that this is a way to engage the consumer and put them in control of things that affect their health,” Burgess said. He said he’s happy Apple is getting into the mHealth game.

PANEL HEARS SKEPTICISM ABOUT JASON PLANS FOR HEALTH IT: Witnesses told a health IT task force Thursday that an ONC-touted plan for interoperability may be too ambitious to work. The Office of the National Coordinator for Health IT created the work group earlier this year to consider the recommendations of the JASON group, a secretive unit of the Mitre Corp. that consults on weighty federal issues, usually related to defense and intelligence. The report, commissioned by the Agency for Healthcare Research and Quality, was published in May. It recommends a major overhaul of electronic health records systems in order to enable the unfettered exchange of patient health data among providers and others. But a group of IT experts expressed skepticism about whether the JASON proposals are doable. Some recommended a more gradual approach that builds on existing EHR software systems. “The JASON recommendations occur during a historic period of competing health reform issues and a national health IT staffing shortage,” said Ted Kremer, of the Rochester Regional Health Information Organization. “As a clinical software person, I think we should build on capabilities we have today and used market-based opportunities to advance. It looks to me like it may take another 10 years to get to interoperability.” More details on the task force hearing are available here.

TIA BACKS THOMPSON’S NEW TELEMEDICINE BILL: The Telecommunications Industry Association Thursday backed the latest bill lowering barriers on the use telemedicine. The group threw its support behind Rep. Mike Thompson’s Medicare Telehealth Parity Act, which the California lawmaker formally introduced Thursday. The legislation would incrementally lower certain restrictions on Medicare payments for the service over a four-year period.

Thompson’s bill is the second telemedicine bill introduced this week, following that of Mississippi Republican Sens. Thad Cochran and Roger Wicker. The American Telemedicine Association has backed both bills.

WHAT WE'RE CLICKING

Physician Rahul Parikh writes on Kevin Pho’s blog that health care efficiency can mean different things to different people: http://bit.ly/1pKq3VB

Slate looks at the emergence of “smart glasses” –not just from Google –and the potential role in health care: http://slate.me/1pKqdwb

MIT Technology Review on the convergence of gene research and Silicon-Valley style computing: http://bit.ly/1pKqhMB